Abstract

Abstract

In the UK, on average 1 in 10 newborn babies (termed neonates until 4 weeks of age) require some sort of treatment in a neonatal unit (NAO, 2007). Neonates on these units may require painful procedures be carried out as part of their diagnosis or treatment, others may suffer tissue damage as part of their condition, while some may suffer both. Pain causes an activation of the sympathetic nervous system resulting in a ‘stress’ response. The physiological and behavioural changes that result, can be used in the assessment of pain and are often incorporated into the basis of pain assessment tools. However, this work questions the very nature of pain assessment – can pain assessment only be carried out through the use of pain assessment tools or are nurses using their professional judgement to assess pain continually? It questions whether waiting for a neonate to show signs of pain is best practice, and highlights that nurses should be predicting, preventing and alleviating pain where ever possible.

This dissertation seeks to question - exactly what is pain assessment? Does a formal pain assessment score need to be documented for a nurse to have ‘performed’ a pain assessment. The work suggests whether the terminology of ‘pain assessment’ may better be phrased as ‘stress measurement’.

In addition to ethical issues that morally mandate nurses as health professionals to prevent and alleviate pain in neonates, this work also discusses the legislation and professional guidelines surrounding pain assessment in this group of patients.

This dissertation is aimed at healthcare professionals, nurses in particular, who work in the neonatal setting to help further their knowledge, question their practice and offer recommendations for their practice.